title: It takes an intensivist.
abstract: BACKGROUND
  Our institution initiated the implementation of the Surviving Sepsis Campaign guidelines in 2006. We hypothesize that the addition of a surgical intensivist improved results more than the implementation of the guidelines alone.
  
  
  METHODS
  We collected data on 273 patients who were admitted to the surgical intensive care unit for sepsis. The groups were divided into pre-bundle, n = 19; bundle, n = 186; and bundle-plus, n = 68, to denote the method by which the patients were treated for sepsis.
  
  
  RESULTS
  There was no difference in age or sex between groups. There was a statistically significant decrease in length of stay (LOS) between the 3 groups, and in mortality between the bundle and bundle-plus treatment groups (P < .01). In addition, there was an average cost savings between each group.
  
  
  CONCLUSIONS
  Implementation of evidence-based guidelines decreased LOS and decreased cost in our surgical intensive care unit. By adding the expertise of a surgical intensivist, we reduced LOS, cost, and relative risk of death even further than using the guidelines alone.
authors.affiliation: St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA.
authors.forename: Lora Z
authors.initials: LZ
authors.lastname: Silverman
authors.forename: L Marco
authors.initials: LM
authors.lastname: Hoesel
authors.forename: Aken
authors.initials: A
authors.lastname: Desai
authors.forename: Patricia
authors.initials: P
authors.lastname: Posa
authors.forename: Mary-Anne
authors.initials: MA
authors.lastname: Purtill
authors.forename: Mary-Margaret
authors.initials: MM
authors.lastname: Brandt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods* / Q000592:standards*; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006801:Humans; D007857:Leadership; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration* / Q000639:trends; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018805:Sepsis / Q000191:economics / Q000401:mortality / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy; D016019:Survival Analysis; D013997:Time Factors